Alex Azar II, the nominee to be the next secretary of the U.S. Department of Health and Human Services (HHS), today told Democratic senators that he will agree with them about many issues but will probably disagree with them about the Affordable Care Act.
Azar talked about the ACA often today at a hearing on his nomination organized by the Senate Health, Education, Labor and Pensions Committee.
Sen. Elizabeth Warren, D-Mass, asked Azar what he thinks about “repealing and replacing” the health law.
“I guarantee that you and I will fundamentally differ on the contours of a system to do that,” Azar told her.
But Azar also praised the Medicare payment reform efforts organized by Sylvia Mathews Burwell, former President Barack Obama’s second HHS secretary, and he said he would do his best to run any Affordable Care act programs that survive as well as he could.
“My job is to faithfully implement the programs as passed by Congress, whatever they are,” Azar told Sen. Bob Casey, D-Pa., earlier in the hearing.
Casey said he believes that officials in President Donald Trump‘s HHS are trying to sabotage the ACA public health insurance exchange system and the HealthCare.gov open enrollment period, by cutting HealthCare.gov advertising spending and funding for HealthCare.gov navigators, or nonprofit exchange plan enrollment helpers.
Azar rejected the idea that Trump administration officials are trying to sabotage the ACA system.
HHS officials are running the open enrollment period as well as they can, but making reasonable program adjustments, such as cutting advertising spending to about the same level as advertising spending for the Medicare Advantage and Medicare Part D prescription drug programs, Azar said.
Azar also talked about how he would run ACA programs in a response to Sen. Patty Murray, D-Wash., the highest-ranking Democrat on the committee.
“Any program HHS has, I want to run it as efficiently and effectively as possible,” Azar said.
Alex Azar II
Trump nominated Azar to succeed Tom Price, who ran into trouble after facing accusations that his travel spending was too high.
Azar was born in Pennsylvania. He has a bachelor’s degree from Dartmouth and a law degree from Yale.
He began his career as a law clerk for U.S. Supreme Court Associate Justice Antonin Scalia.
From 1994 through 1996, he was a junior lawyer in the federal office that investigated former President Bill Clinton’s real estate investments.
After a stint as a lawyer at a big law firm, he moved over to HHS. He started out in 2001, under former President George W. Bush, as the HHS general counsel. In 2005, he won Senate confirmation to become the HHS deputy secretary.
From 2007 through 2012, Azar worked for the U.S. unit of Eli Lilly and Company, a pharmaceutical manufacturer. He was the head of the U.S. unit from 2012 through 2016.
The Senate HELP was just his first. He will also have to get through a hearing at the Senate Finance Committee before his nomination can get to the Senate floor for a full vote.
The Senate HELP Committee posted documents related to the hearing, and a video recording of the committee’s hearing, here.
Here’s a look at five more interesting things Azar said at the hearing, drawn from the hearing video.
Sen. Patty Muray, D-Wash. (Photo: Senate HELP)
1. He likes the Obama administration’s efforts to move the Medicare program toward more use of value-based reimbursement.
For Medicare policymakers, “value-based programs” can mean efforts to pay more for high-value care, such as important and useful vaccinations, and less for care that may do little to affect outcomes, such as X-rays that may not have much effect on treatment decisions.
“Value-based programs” may also refer to efforts to pay a doctor or hospital for full treatment of a health problem, or for care for a whole patient for a whole year, rather than on a fee-for-service basis.
Azar said he sees Medicare provider payment pilot programs as important legacies of Burwell’s tenure at HHS.
“I would like to keep doing that,” Azar said.
Azar said improving Medicare is important to improving the entire U.S. health care and health finance system, because Medicare is so much bigger than any other public or private U.S. health care program.
“So much of the health care system really free rides off of whatever Medicare is doing,” Azar said.
2. Azar likes the U.S. Centers for Disease Control and Prevention (CDC).
The CDC is part of HHS.